Child Care Policy Should Serve Children, Not Just Adults

Once a progressive longshot, universal child care has entered the American policy mainstream. New Mexico’s recently launched universal child care program is now in the spotlight, with other states primed to follow—pitched as a solution to a “child care crisis” of high costs, limited access, and inadequate supply. The left stresses child care as essential to increasing family income and enabling women’s careers; the right emphasizes its importance to meeting business workforce needs and promoting economic growth.

Yet there’s a glaring gap in the case for expanding child care: what’s best for young children—the ones with the most at stake, whom no one is actually discussing. Women’s careers matter. A strong workforce matters. The economy matters. But those whose lives are most profoundly shaped by a big expansion of child care are barely mentioned by the adults promoting it.

What Young Children Need

This omission is all the more striking because we have never known more about what young children need. Developmental science has established that the bedrock of human flourishing is formed in the first years of life—not through flashcards and circle time, but through the ongoing, intimate connection with loving caregivers that drives brain development and lays the groundwork for everything that follows. 

From their first months, babies are designed to form deep attachments to the few people closest to them—those who know them best and respond sensitively and consistently across thousands of small daily exchanges. Within these first relationships, a child's security, sense of self, and capacity to trust and connect with others are established, forming the foundation for lifelong well-being. 

What young children need above all else cannot be met by proxy—only by the particular people to whom they are deeply attached.

Any policy that dramatically shifts who cares for young children, and for how many hours a day, touches that foundation directly. The first question to ask about expanding child care, then, is how it will affect the day-to-day loving interaction young children depend on for healthy development?

Young children, however, do not participate in policy debates, and that question is rarely asked. Pitted against adult preferences and economic priorities, their needs are easy to set aside. When children’s needs are highlighted, child care advocates invoke economic imperatives and the specter of women sent back home "barefoot and pregnant," redirecting the discussion back to adult concerns. Parents, businesses, and the economy need child care to thrive, we're told. And “the kids are alright”: indeed, the claim goes, high-quality, non-parental group care is actually good for young children.

But is it? 

What the Evidence Shows

The most important US study of child care’s effects, the NICHD Study of Early Child Care and Youth Development, suggests otherwise. The study tracked nearly 1,000 children from infancy into adulthood, finding worrisome effects across development. At 15 months, more time in child care predicted increased risk of insecure infant-mother attachment. At 24 months, signs of behavior problems surfaced. By age 3, effects seemed to disappear, and many concluded the worry was over. But when researchers reassessed at age four-and-a-half, a very different picture emerged.

Among children who averaged under 10 hours per week of non-parental group care across their first four-and-a-half years, only 5% had elevated behavior problems. But children who had spent at least 30 hours per week in those settings beginning in infancy had three times the rate of social-emotional difficulties, including lower social competence, higher externalizing behavior, and more conflict with teachers and peers. These effects persisted through elementary school, and by adolescence appeared as impulsivity, risk-taking, and substance use. They remained after controlling for program quality, maternal education, family income, and child temperament. Strikingly, time in non-parental group care predicted behavior problems more strongly than family income did.

The negative effects researchers observed did not show up immediately. They emerged across years, often remaining invisible until children were in school. And those effects appeared not in cognitive outcomes, but in social-emotional development—the very capacities established within children’s earliest loving relationships. 

Researchers have found similar patterns in child care studies around the world, including Germany, Chile, and France. Quebec’s much-studied universal child care program, launched in 1997 with aims like those now driving US proposals, has been associated with increased anxiety, aggression, hyperactivity, worse parent-child relationships, and lower self-reported life satisfaction in adolescence. By young adulthood, the negative effects extended to a 22% increase in criminal conviction rates.

The broader research confirms that spending long hours in non-familial, often institutional, group care is not optimal for most young children. 

Aiming to counter these accumulating negative findings, child care advocates have recently highlighted an analysis of combined data from seven major longitudinal studies as showing no adverse effects of children’s time in childcare. But the question that analysis examined was whether short-term increases in child care hours predicted short-term increases in children’s behavior problems. The methodology the investigators used simply wasn’t designed to detect what the NICHD study found: that the cumulative weight of extensive hours across infancy, toddlerhood, and the preschool years is what puts children at risk over years to come.

Cause for Concern

It would be a mistake to catastrophize these findings. Not all children who spend long hours in non-parental group care show negative effects, and behavior problems generally do not rise to the level of clinical disturbance. Some children clearly benefit from high-quality child care programs, especially those from less stable, lower-income homes. Those children deserve our investment and best efforts to provide them with truly high-quality programs. But the broader research confirms a conclusion we have been much too quick to dismiss: spending long hours in non-familial, often institutional, group care is not optimal for most young children. 

The negative findings from child care studies may be at least partially explained by a physiological mechanism: children's stress response in child care, measured by cortisol, the body's stress hormone. Over the first months of life, young children develop a normal daily cortisol rhythm with highest levels in the morning, which then steadily decline. But research consistently finds that for many children in full-day child care, this pattern reverses: cortisol rises across the day, returning to its normal rhythm on days spent at home. Fewer hours and more responsive caregivers blunt the effect, but the underlying pattern remains. And we know that a prolonged pattern of stress in the first years of life can pose a threat to long-term health and the developing brain.

These research findings are not an isolated signal that we are failing to meet children's needs. Rates of anxiety, depression, and suicidality among children and adolescents have risen dramatically. The causes of that rise are disputed; its reality is not. And it is occurring in precisely the domain where the child care research has found negative effects: children's social and emotional well-being. The kids are not alright.

Whose Interests Are Served?

Why are we so willing to set children's needs aside? Because a workist orientation has eclipsed a familist one—we now largely locate human identity and value in paid work rather than in family and relationships. And from within a workist frame, young children's day-to-day, hour-to-hour needs for our time and attention and love are hard to accommodate and easy to ignore.

What young children need above all else cannot be met by proxy—only by the particular people to whom they are deeply attached. Yet at its root, the aim of expanding child care is to maximize our time away from young children, thus minimizing exactly what they need most. In short, child care policy is adult policy, not early childhood policy—designed to increase the well-being not of young children but of adults.

This aim is backward. Early childhood policy must be driven by what young children need from us, not the other way around. When the interests of young children and adults conflict, our focus, our advocacy, and our public funds should be directed toward advancing their best interests—not our own.

Katharine B. Stevens is founder and president of the Center on Child and Family Policy. Jenet Erickson is Non-resident Senior Fellow in Maternal and Child Well-Being for IFS and an associate professor in the Department of Church History and Doctrine in Religious Education at BYU.

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